尿乳酸/肌酐比值在新生儿窒息预后评估中的应用价值  

Application value of urinary lactate/creatinine ratio in prognosis evaluation of neonatal asphyxia

作　　者：刘晓丹[1] 高玉先[2] 任静[1] 张敏敏[1] 严超英[3] 

机构地区：[1]吉林大学护理学院儿科教研室,吉林长春130021 [2]吉林大学第二医院新生儿科,吉林长春130041 [3]吉林大学第一医院新生儿科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2014年第3期655-658,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(201105023)

摘　　要：目的:探讨尿乳酸/肌酐比值与新生儿窒息发生的关系,阐明尿乳酸/肌酐比值在预测新生儿缺氧缺血性脑病(HIE)中的应用价值。方法:采用病例-对照研究设计方法,选取40例发生窒息的新生儿患者为窒息组,40名健康新生儿作为对照组。检测出生后1d新生儿尿乳酸/肌酐比值、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)/肌酐比值和Apgar评分,分析窒息组与对照组新生儿尿乳酸/肌酐比值、尿NAG/肌酐比值与新生儿HIE发生的关系。结果:窒息组新生儿1-min和5-min Apgar评分明显低于对照组(P<0.01);窒息组新生儿生后1d尿乳酸/肌酐比值及尿NAG/肌酐比值明显高于对照组(P<0.01);窒息组新生儿生后1d尿乳酸/肌酐比值与1-min和5-min Apgar评分均呈负相关关系(r=-0.636,P<0.01;r=-0.883,P<0.01),窒息组新生儿生后1d尿乳酸/肌酐比值与尿NAG/肌酐比值呈正相关关系(r=0.433,P<0.01)。结论:尿乳酸/肌酐比值对新生儿窒息的预后评估具有重要作用,同时可作为早期预测新生儿HIE的重要依据。Objective To explore the association between urinary lactate/creatinine ratio and neonatal asphyxia,and to clarify the application value of urinary lactate/creatinine ratio in forecasting the hypoxie-ischemic encephalopathy （HIE）in neonates.Methods Using case-control study design method,40 cases of neonatal asphyxia infants were selected as asphyctic group and 40 healthy infants were used as control group.The urinary lactate/creatinine ratio in the first day after birth, urinary N-Acetyl-β-D-glucosaminidase （NAG）/creatinine and the score of Apgar of 80 infants were detected.The relationship between the urinary lactate/creatinine ratio,urinary NAG/creatinine ratio, as well as the score of Apgar and HIE were analyzed and compared in asphyctic group and control group.Results The Apgar scores at 1 and 5 min in asphyctic group were significantly lower than those in control group （P〈0.01）. The urinary lactate/creatinine ratio and urinary NAG/creatinine ratio in asphyctic group 1 d after birth were significantly higher than those in control group（P〈0.01）.There was significantly negative correlation between the urinary lactate/creatinine ratio and the 1-min and 5-min Apgar scores（r=-0.636,P〈0.001;r=-0.883,P〈0.01）,but there was a significantly positive correlation between the urinary lactate/creatinine ratio and urinary NAG/creatinine ratio（r=0.433,P〈0.01）.Conclusion The urinary lactate/creatinine ratio may have decisive＆amp;nbsp;roles in prognosis evaluation of neonatal asphyxia,and so as the important foundation for the prediction of HIE.

关 键 词：新生儿窒息 乳酸 N-乙酰-Β-D-氨基葡萄糖苷酶 肌酐 

分 类 号：R726.492[医药卫生—儿科]